Treatment for Tethered Oral Tissues (TOTs)

A frenectomy is a delicate surgical procedure to release restrictions caused by a tongue-tie or lip-tie, which are short, tight membranes that restrict tongue and lip movement. The frenectomy is done with our Waterlase™ laser with little to no anesthetic, no pain, and typically no bleeding. The procedure takes only a few moments. While Dr. Rogers performs these frenectomy procedures on patients of all ages, he is one of the few practitioners in the area who is experienced in treating infants as young as 24 hours old.


For your convenience, consultations and procedures may be done at the same visit. Parents are welcome to stay in the room during the procedure if requested. Immediately after the procedure, our comfortable, private breastfeeding area is available for you to bond with your baby.

Infant symptoms of tongue-tie/lip-tie may include the following:
  • Poor or unsustainable latch
  • Clicking noises with baby repeatedly “clicking off” the breast while feeding
  • Exhaustion and falling asleep at the breast before full
  • Frequent coughing or choking on milk
  • Gasping for air mid-feed
  • Frequent release and re-latch
  • Unsatisfied after prolonged feeds
  • Poor weight gain/failure to thrive
  • Gas/reflux/colic/hiccups due to swallowing of air
  • Frequent and prolonged nursing sessions
  • Fussing, fighting, or crying or seeming frustrated during feeding sessions
  • Lip blisters
  • Milk leaking from the corners of the mouth during feeding
  • Gumming and chewing on the nipple
  • Unable to open wide to latch
Some symptoms for breastfeeding mothers include the following:
  • Severe pain during breastfeeding
  • Poor or incomplete milk transfer (breasts don’t feel emptied after feedings)
  • Undersupply or oversupply
  • Mastitis and/or thrush
  • Cracked, sore, or damaged nipples


For those who do not undergo frenectomy in infancy, potential complications may include the following:
  • Poor oral hygiene (due to the tongue not having freedom to effectively cleanse the oral cavity)
  • Difficulty swallowing or the development of an abnormal swallow pattern such as tongue-thrust
  • Loud slurping/gulping sounds when eating
  • Needing to drink a lot during eating
  • Messy eating
  • Choking/gagging easily
  • Disruption of normal oral and facial development
  • Low resting tongue posture
  • Sleep-disordered breathing/sleep disturbances
  • Delayed speech or significant speech impediments
  • Gum recession
  • Cavities
  • Periodontal disease
  • Tightness of the neck and shoulders
  • TMJ symptoms
  • Headaches/migraines
  • Orthodontic concerns such as an open bite, gaps, tipping of teeth
  • Social concerns (licking an ice cream cone, kissing)